Eosinophilic folliculitis presents as intensely pruritic 2-3 mm erythematous oedematous urticarial papules centred on follicles and may have pustules. The distribution is typically over the forehead, neck, shoulders, trunk and upper arms. In women living with HIV, PPE may more predominantly involve the face and therefore mimic acne excoriae. (138) Due to the associated pruritus, excoriations with secondary Staphylococcal infection, prurigo nodularis, lichen simplex chronicus and postinflammatory pigmentary changes are common. (134) 

PPE appears as multiple papules, typically symmetric, on the trunk and extensor surfaces of the extremities, as well as on the face, with sparing of the palms and soles.  (135) Because of the chronic nature of PPE, like with EF, papules are often excoriated and develop post-inflammatory hyperpigmentation and scarring. Over time, severe inflammation exacerbated by persistent scratching causes the papules to become nodular in appearance. (136)